NPIMap

Organization Active NPI

Family Foot and Ankle Center Inc

  • Foot & Ankle Surgery Podiatrist
  • Bloomington, IN
National Provider Identifier
1497957161
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
07000762A Issued in IN
Legal business name
FAMILY FOOT AND ANKLE CENTER INC
Practice address
417 S. Landmark Avenue
Bloomington, IN 47403-5003
Phone
(812) 339-2446
Fax
(812) 330-9508
NPI assigned
Jun 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Gerry L Hash, DPM
Title
President
Phone
(812) 339-2446

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 07000762A IN Primary

Addresses

Primary practice location

417 S. Landmark Avenue
Bloomington, IN 47403-5003

Mailing address

417 S. Landmark Avenue
Bloomington, IN 47403-5003
Phone (812) 339-2446

Other identifiers 4

IdentifierTypeStateIssuer
100184940MedicaidIN
000000089196OtherINBLUE CROSS
100184940AMedicaidIN
P00327018OtherINPALMETTO GBA

National Provider Directory

National Provider Directory

Locations

417 S Landmark Ave
Bloomington, IN 47403
Phone (812) 339-2446

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1497957161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 S. LANDMARK AVENUE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474035003",
            "telephone_number": "812-339-2446",
            "fax_number": "812-330-9508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 S. LANDMARK AVENUE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474035003",
            "telephone_number": "812-339-2446",
            "fax_number": "812-330-9508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY FOOT AND ANKLE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-04",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "HASH",
        "authorized_official_first_name": "GERRY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "812-339-2446",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IN",
            "license": "07000762A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100184940",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "000000089196",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100184940A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "P00327018",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.